Successful Retrieval of Intravascular Stent Remnants With a Combination of Rotational Atherectomy and a Gooseneck Snare

Abstract

Stent migration from the delivery balloon catheter is a rare but serious complication during percutaneous coronary intervention, particularly when a part of the stent stretches into the aorta. We report an unusual case of stent migration treated with a combination of a gooseneck snare and rotablation. A part of the stent was overstretched and unrolled into the aorta and the rest of the stent remained implanted in the coronary artery. The stent was captured with a gooseneck snare but could not be retrieved because it was connected to a stent remnant implanted in the coronary artery. The stent strut was cut with rotablation, and the stent was successfully removed through the femoral sheath.

Extraction of a Fully Deployed Coronary Stent during Retrieval of Another Dislodged Stent

“…Percutaneous retrieval can be a good therapeutic option when the clinical situation and the patient's vital signs are stable. Several percutaneous retrieval techniques using a snare,4) wire,5) and balloon6) have previously been established and a number of unique cases have been reported 7)8)…”

Retrieval of a dislodged and dismounted coronary stent; using a rendezvous and snare technique at the brachial artery level via femoral approach

“…The reported incidence of dislodgement is approximately 0.32-8% [2]. When stent dislodgement occurs, removal from the arterial system is the best option and there are various retrieval techniques: catheter balloon inflated distal to the undeployed stent (small-balloon technique) [3], retrieval using a snare [4] or forceps [5], stent entrapment with two twisted guidewires [6], combination of rotablation and snaring [7], and basket devices [8]. When a retrieval method is not feasible, 'bail-out crush technique' using another stent is another option.…”